Oatmeal interventions in severe insulin resistance on the intensive care unit: A case report

ObjectivesTo report on the potential effectiveness of hypocaloric, plant-based short-term dietary oatmeal interventions in the treatment of insulin resistance in critically ill patients on the intensive care unit.Clinical features and outcomeA 67-year-old female with type 2 diabetes was admitted to our hospital with suspected pneumonia. The patient developed acute hypoxemic respiratory failure and was diagnosed with pneumogenic sepsis requiring invasive ventilation and an immediate transfer to our medical intensive care unit. Within 48 h the patient developed severe to extreme insulin resistance and required more than 200 units of insulin per day.Based on the “Noorden diet” described in 1903, a modified hypocaloric (700 kcal) and plant-based dietary oatmeal intervention was performed to “break” insulin resistance and to improve glycaemic control. For two days, the patient received a low-fat diet that restricted carbohydrates to whole-grain oats (180 g) and included small amounts of vegetables (60 g). Enteral feeding was done via nasogastric tube. During and after the intervention, glycaemic control improved significantly. A significant reduction in total daily insulin requirements was achieved during and after the intervention.ConclusionsHypocaloric, plant-based short-term dietary oatmeal interventions significantly reduced mean blood glucose levels and mean required daily insulin doses in a critically ill and septic patient on the intensive care unit.